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While I laboured, 639 women died

Jo Pride

"Improving access to quality medical services is important. We also need to increase access to family-planning methods." Photo: Jacky Ghossein

As the birth of my second child approached, I found - on top of the behemoth belly with a mind of its own - I was again confronting the complex cocktail of emotions many women face as they prepare to bring their child into the world.

There was excitement about holding my newborn for the first time, feeling her fingers wrap around mine. I wondered how my son would react to her arrival. And there was anxiety. After one emergency caesarean, how would this birth go?

Mothers in East Timor face a one-in-44 chance of dying in pregnancy or childbirth; almost all Timorese will know a woman who has died this way.

Yet not once - not when I haemorrhaged at the outset of an early labour with a toddler asleep and a husband interstate, nor when I was wheeled into theatre for a caesarean the following afternoon - did I fear for my life.

Why would I? I've never known anyone who has died giving birth. Not in this day and age. Not in Australia.

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That was a few months before the tragic, much-reported death of home birth advocate Caroline Lovell in January. I didn't know Caroline but we were the same age, lived in the same city, and had been pregnant with our second children - both girls - at the same time. I was deeply saddened to read of her death and have found myself thinking of her and the young family she left behind.

The fact that Caroline's death was so widely reported demonstrates just how rare it is for an Australian woman to die as a result of childbirth. Yet, just a few hundred kilometres north of Australia, it's so common that their deaths - while equally devastating to their families and communities - aren't newsworthy.

Mothers in East Timor face a one-in-44 chance of dying in pregnancy or childbirth. This means almost all Timorese will know a woman who has died in these circumstances.

And how is it in a country such as Papua New Guinea - where the capital is closer to Cairns than Queensland's capital, Brisbane - the percentage of women who die in childbirth has more than doubled over the past decade? These aren't just statistics. They are daughters, sisters, wives and mothers who never should have died.

The sickening reality is that, in the 16 hours from when I started labour to when I gave birth, an estimated 639 women around the world died as a result of complications relating to pregnancy or childbirth. Worse still, most of those deaths - and the thousands since - could have been prevented.

So what needs to be done?

Improving access to quality medical services is important. We also need to increase access to family-planning methods. It's estimated 215 million women in developing countries would use family planning if they had access to it.

But by far the most effective action is to empower women. As highlighted by the United Nations' agency for the empowerment of women, we need to support not only access to family planning, but also women's bargaining power to negotiate family-planning methods. Women also need greater decision-making power in the health sector.

Above all, we need to increase girls' access to education and opportunities. Women with secondary education on average have fewer children and have them more safely.

What can we personally do to help?

Large, reputable charities are increasingly focusing on women's rights, so supporting their work can make a real difference.

But there are also several smaller organisations that focus solely on women's rights, such as the Alola Foundation, started by Melbourne-born former first lady of East Timor, Kirsty Sword Gusmao, to improve the lives of Timorese women.

An innovative new organisation, Send Hope Not Flowers, encourages Australians to make a donation to maternal health programs in PNG and Indonesia instead of sending flowers when a baby is born. Its slogan: ''Because flowers die. Women giving birth shouldn't''.

As the world's seventh largest national aid donor, the Australian government also has an important role to play in reducing the number of maternal deaths, particularly in our region. The Australian aid program is already doing some good work on women's empowerment, but could do more to prioritise it.

It's hard to imagine now, but in 25 or so years my baby girl may start to think about starting her own family. As may many of the young women who share her birthday of November 2, hundreds of whom lost their mothers on that day. I hope they'll all have the same opportunity to start their families safely.

Jo Pride is on maternity leave from her role as the advocacy manager at Oxfam Australia.

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